tbuckley/cabot-search huggingface dataset:
Effects of Hypoglycemic Agents on Vascular Complications in Patients With Adult-Onset Diabetes
Authors: Genell L. Knatterud
Journal: JAMA (1971)

The University Group Diabetes Program (UGDP), a long-term prospective clinical trial, was designed to evaluate the effects of various hypoglycemic agents on vascular complications in patients with asymptomatic, adult-onset diabetes. This study provided no evidence that phenformin was more efficacious than diet alone or than diet and insulin in prolonging life for the patients studied. In fact, the observed mortality from all causes and from cardiovascular causes for patients in the phenformin treatment group was higher than that observed in any of the other treatment groups. In addition, there was no evidence that phenformin was more effective than any of the other treatments in preventing the occurrence of nonfatal vascular complications associated with diabetes. For these reasons, the use of phenformin has been terminated in the UGDP. Data collection in this study is continuing for all surviving patients. The additional information obtained over a longer period of follow-up on patients in the two insulin groups compared with the patients in the placebo group will provide a more adequate basis for the assessment of the long-term effects of insulin.
Central Venous Catheterization Via the External Jugular Vein
Authors: Casey D. Blitt
Journal: JAMA (1974)

CENTRAL venous pressure (CVP) measurement provides valuable clinical data during the perioperative period. A variety of routes and techniques for obtaining CVP data have been described. Cannulation of the antecubital vein is easy, but passage of a long catheter to a central location from the antecubital site is frequently difficult and unsuccessful. Cannulation of the subclavian or internal jugular vein provides reliable and accurate CVP, but is technically demanding and has resulted in severe complications. Peripheral venous pressure measurement from the external jugular vein can accurately reflect CVP, but is position-dependent and often unreliable. Passage of a catheter into a central venous position via the external jugular vein is very difficult with present methods. This study was designed to evaluate an easy, dependable, and safe method of catheter placement in the superior vena cava via the external jugular vein, employing a flexible angiographic wire catheter guide (J-wire). <h3>Methods</h3> A pilot
Clinical Features of Sudden Obstruction of the Coronary Arteries
Authors: James B. Herrick
Journal: JAMA (1983)

Obstruction of a coronary artery or of any of its large branches has long been regarded as a serious acci- dent.Several events contributed toward the prevalence of the view that this condition was almost always sud- denly fatal.Parry's writings on angina pectoris and its relation to coronary disease, Jenner's observations on the same condition centering about John Hunter's case, Thorvaldsen's tragic death in the theater in Copen- hagen with the finding of a plugged coronary, sharply attracted attention to the relation between the coronary and sudden death.In Germany Cohnheim supported the views of Hyrtl and Henle as to lack of considerable anastomosis, and as late as 1881 lent the influence of his name to the doctrine that the coronary arteries were end-arteries; his Leipsic necropsy experience, as well as experiments on dogs, forced him to conclude that the sudden occlusion of one of these vessels or of one of the larger branches, such as the ramus descendens of the left coronary, meant death within a few minutes.Other3 emphasized the same view.No one at all familiar with Ihe clinical, pathologic or experimental features of cardiac diseuse can question the importance of the coronarios.The influence of scle- rosis of these vessels in the way of producing anemic necrosis and fibrosis of the myocardium, with such pos- sible results as aneurysm, rupture or dilatation of the heart, is well known.So also is the relation of the coronaries to many cases of angina pectoris, and to cardiac disturbances nil her indefinitely classed as chronic myocarditis, cardiac irregularities, etc.It must be admitted, also, thai the reputation of the descending branch of the left coronary as the artery of sudden death is not undeserved.Hut there are reasons for believing that even large branches of the coronary arteries may be occluded at limes acutely occluded-without resulting death, at least wilhoiil death in Hie immediate future.Even the main trunk-may at times be obstructed and Ihe patient live.II.¡s Ihe object of this paper to present a few facts along Ibis line, and particularly to describe some of the clinical manifestations of sudden yet not immediately filial eases of coronary obstruction.Before presenting the clinical features of coronary obstruction, if may be well to consider certain facts that go to prove that sudden obstruction is not neces- sarily fatal.Such proof is afforded by a study of the anatomy of lite normal as well as of the diseased heart, by animal experiment and by bedside experience.
The Cytomegaloviruses: Ubiquitous Agents with Protean Clinical Manifestations
Authors: Thomas H. Weller
Journal: New England Journal of Medicine (1971)

FIFTEEN years have elapsed since the human cytomegaloviruses (CMV) were first isolated.1 2 3 During this period a partial understanding of the host-parasite relations of these unique viruses has materialized. A fascinating picture emerges of agents that may infect by diverse natural or iatrogenic routes, with man at risk from time of conception. Few humans escape infection during life. Overt evidence of infection — at least as now recognized — may be lacking, although the spectrum of disease known to be produced by the CMV continues to expand. Indeed, the variable consequences of infection are so broad as to impinge in some . . .
The Deprofessionalization of Medicine
Authors: Ralph R. Reed
Journal: JAMA (1987)

In this article, we examine the components of medical professionalism; identify the roots of the loss of professional autonomy by physicians in the United States—a process that, in effect, is leading to the deprofessionalization of American medicine; discuss why such deprofessionalization is undesirable for the society; and explore three health care delivery systems and their effects on deprofessionalization. We suggest that a system based on organizations set up and directed by physicians will be the system that best preserves medical professionalism and serves the public interest. (<i>JAMA</i>1987;258:3279-3282)
Cancer of the Head and Neck
Authors: Philip Rubin
Journal: JAMA (1971)

Cancersd and neck are a model for the mangement of other cancers. The manner in which these lesions are managed reveals the basic philosophies of the oncology services in a hospital; they may weld or disband a multidisciplinary team. Oncology specialties need to be well developed and integrated to provide the best in patient care. Survival results reflect the length of life; however, both the quality and quantity of survival are marks of the cancer therapist. "Cancer of the head and neck" is a misnomer; these cancers could be more accurately named "cancer of the upper respiratory and alimentary passages" since brain tumors and orbit tumors are not included in this term. Nevertheless, historical usage has defined their scope. The perpetuation of the term is justified by emphasizing that the management of the mucosal surfaces in the head often depends on whether there is spread into cervical lymph nodes. The
Editorial: The sickle cell complexity
Authors: I. M. Rutkow
Journal: JAMA (1974)

Since passage of the National Sickle Cell Anemia Control Act on May 16, 1972, the American public has become increasingly aware of sickle cell disease. This growing cognizance led to the establishment of mass sickle cell anemia testing (SCAT) programs, as well as the institution, in various states, of legislation requiring mandatory screening. With such legislation and mass testing, medical and social questions have arisen concerning previously unconsidered problems associated with the detection of sickle cell anemia and trait. Many investigators regard the trait as a benign condition. However, reports of associated morbidity during periods of "extraordinary physiological stress"<sup>1</sup>have generated much controversy regarding its true nature. Additional discussion concerns the effectiveness of mass screening programs for a genetic disease, with a benign carrier state, that has no treatment or preventive modalities presently available other than ineffectual genetic counseling. Since the principal outcome of current mass SCAT programs is
Diagnosis of Plumbism
Authors: Ralph D. Caldroney
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The recent article by Bird et al inThe Journal(1982; 247;813) was a vivid example of the surreptitious manner in which lead intoxication can present itself. This case also points out the difficulty in diagnosing lead intoxication unless sensitive and specific tests are used. The "best" test for the diagnosis of lead storage disease has been a subject of considerable debate.<sup>1,2</sup>Most of the currently available tests are centered around lead's interference with heme synthesis or they directly assay lead levels in serum or urine.<sup>3</sup>As described in this case, those tests based on measuring alterations in heme synthesis, though sensitive, are far from being specific. While one would assume that direct assays of lead levels would solve the problem of lack of specificity, this is not the case. The problem revolves around the manner in which lead is stored in the body, especially
Errors in blood transfusion.
Authors: D A Osborn
Journal: BMJ (1967)

paediatric and psychiatric centres do a considerable amount of investigation which might elsewhere be done in hospitals for the subnormal."Unfortunately, none of these statements is in keeping with the facts.Apart from its " compact " nature not being obvious to me, " centres " in Birmingham have been unable to carry out all the investigations necessary, while in other parts of the country hospitals for the subnormal are generally not equipped to carry them out either.
Response to "More is not always better: a case for low-dose leucovorin".
Authors: S Fischkoff, K Martin
Journal: Journal of Clinical Oncology (1993)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1993.11.7.1434 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 8315444 Response to "More is not always better: a case for low-dose leucovorin". S FischkoffxS FischkoffSearch for articles by this author , K MartinxK MartinSearch for articles by this author https://doi.org/10.1200/JCO.1993.11.7.1434 PDF "Response to "More is not always better: a case for low-dose leucovorin".." Journal of Clinical Oncology, 11(7), pp. 1434–1435© 1993 by American Society of Clinical Oncology
The Tuberculin Test in 1980
Authors: William R. Barclay
Journal: JAMA (1980)

Although morbidity and mortality from tuberculosis have shown substantial declines, this disease remains an important diagnostic challenge. Its early recognition usually results in a cure, with minimal disruption of the patient's work and family commitments. The most important step in establishing a diagnosis of tuberculosis is to think of the disease as a possible cause of the patient's illness. Once tuberculosis has been entered into the list of differential diagnoses, then appropriate steps can be taken either to establish its presence or to rule it out. The tuberculin test is useful but not diagnostic when tuberculosis is suspected but has little value today as a screening test. The prevalence of tuberculosis is so low in 1980 that screening is not cost-effective, and as described by Bryan in this issue ofThe Journal(p 1126), administration and interpretation of the test are so erratic that results of such screening are not
Theranostic Upconversion Nanoparticles (II)
Authors: Gang Han, Guanying Chen
Journal: Theranostics (2013)

This theme issue provides a comprehensive collection of original research articles as well as reviews on the creation of diverse types of theranostic upconversion nanoparticles, their fundamental interactions in biology, as well as their biophotonic applications in noninvasive diagnostics and therapy.
Nicholas Copernicus
Authors: Mieczyslaw Skulimowski
Journal: JAMA (1964)

NICHOLASCOPERNICUS, future genial astronomer and eminent physician of Poland, was born in 1473 into a well-to-do middle-class family, which had emigrated from Lower Silesia to Cracow and finally to Toruń a century earlier.<sup>1</sup>Thus Nicholas' early associations were with the class of craftsmen; later they were with the wealthy merchant class. Because his father died when Nicholas was yet a boy, he was reared by his uncle, Lucas Waczenrode, bishop of Varmia, who, in accord with the times, prepared him for the clerical state. The young Copernicus' teacher was the well-known practical physician, humanist, and astronomer, Nicholas Wodka of Kwidzyn on the Vistula. At the age of 17 Copernicus assisted his preceptor in adorning the wall of the cathedral in Wloclawek with a fine sundial.<sup>2</sup>Presumably, Dr. Wodka also aroused his pupil's interest in medicine. The face of the Cracow University at the end of the 15th century
Binge Drinking in College
Authors: Philip W. Meilman
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Dr Wechsler and colleagues<sup>1</sup>have made an important contribution to the field in their recent publication examining alcohol use among college undergraduates. Their discussion of secondary binge effects—akin to secondhand smoking—adds a novel and interesting dimension to the dialogue. Further, the identification of gender-specific operational definitions of binge drinking provides a new way of looking at data on college women. However, the assertion that this is the first representative national study of collegiate drinking is an overstatement. There are two active and preexisting national databases: the Core Alcohol and Drug Survey<sup>2</sup>managed by the Core Institute at Southern Illinois University, Carbondale, and the Monitoring the Future Project<sup>3</sup>administered by the Institute for Social Research at the University of Michigan, Ann Arbor. Both projects maintain extensive databases and have contributed to the field by carefully examining and reporting on their research findings. The work of
More on the First Pneumonectomy
Authors: Seymour Fiske Ochsner
Journal: JAMA (1976)

<h3>To the Editor.—</h3> As a radiation therapist, I was interested in the discussion in the letters to the editor concerning the operability of bronchogenic carcinoma (233:1165, 1975). Drs Gueldner and Lawrence were commenting on an article by Dr Irwin Stoloff concerning identification of tumor in a stem bronchus as a contraindication for surgical intervention in bronchogenic carcinoma (227:299-301, 1974). Gueldner and Lawrence recalled the case of Drs Graham and Singer (101:1371-1374, 1933) who performed the first pneumonectomy and whose patient lived for 30 years despite positive lymph nodes. It is rarely mentioned by surgeons that Graham and Singer used a radon-seed implant after the one-stage pneumonectomy, which was performed on April 5, 1933, in St Louis. They reported, "... seven radon seeds of 1.5 millicuries each were inserted into various parts of the stump." There has recently been a reawakening of interest in the use of interstitial radiation therapy. It might
The Ebb and Flow of Infection
Authors: Ervin Epstein
Journal: JAMA (1976)

<h3>To the Editor.—</h3> I read with great interest the article by Thomson (235: 269, 1976). It is significant that the great epidemic diseases of the past— plague, typhoid fever, typhus, smallpox, and diphtheria—waxed and waned for actual or supposed reasons, or even without them. The same has happened with certain plagues of today. For instance, there is little or no reason to accept the thesis that the use of penicillin or public health measures or both are the explanation for a decrease in syphilis. If a curve of the incidence of that disease had been constructed and had ignored the peaks due to wars and depressions, it could have predicted that this scourge would have become rare in the 1950s. It waned in countries that did not have penicillin. It persisted in the male homosexual who had as much penicillin for various ailments as did the heterosexual. The condition is
To Dot Plot Or Not
Authors: Ross J. Simpson
Journal: JAMA (1989)

<h3>To the Editor. —</h3> Krieg et al<sup>1</sup>advocate the use of a computerized tablet to extract data from published dot plot graphs when tables of data are not available. The implication is that this technique has sufficient accuracy to reconstruct data tables or at least to enumerate data points within intervals of the data distribution. Although the authors were not attempting to reproduce exact data values, they seem to have had difficulty defining the boundaries of their chosen intervals and reproducing the number of dots in each interval. In reviewing one of the original research articles,<sup>2</sup>it is apparent that the number of counts by their computerized system is inaccurate. In particular, clinical state A should have 30 patients in the first interval and two in the second, whereas only 29 patients in the first interval and two in the second are shown. This error is repeated in
Communicating With Deaf Patients
Authors: Elizabeth Ralston
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The little research that has been done on the health status of deaf and hard-of-hearing (D&amp;HH) people suggests that they have altered health care utilization patterns and poor health status. The last National Health Interview Survey to study this in D&amp;HH people revealed that they see physicians more often, have more bed days due to illness, and rate their health as poorer than persons with normal hearing.<sup>1</sup>Our more recent data confirmed this and found it unclear whether this is due to poor physician-patient communication, inadequate health care information, coexisting chronic medical conditions, or cultural differences.<sup>2</sup>The article by Drs Ebert and Heckerling<sup>3</sup>is a welcome addition to the sparse literature on this problem that adds ammunition to the fact that there is poor physician communication with deaf patients. Most health care personnel know little about deafness and how D&amp;HH people communicate.<sup>4</sup>Physicians'
Arterial and venous disease and deep vein thrombosis
Authors: D. Crossley
Journal: BMJ (2000)

Plan represents considerable privatisationEditor-Dixon and Dewar's editorial welcomes the considerable injection of money promised in the NHS plan and claims that the plan is true to the NHS's founding principles. 1 Yet Aneurin Bevan's greatest achievement, and not one demanded of him by the Beveridge report, was the nationalisation of hospitals.He recognised that ownership was important, because with ownership comes control.The NHS plan promises 100 new hospitals by 2010 (69 of which are already in the pipeline).This will involve £7bn of new investment under the private finance initiative.Together with the new plans for some NHS operating to be carried out in the private sector, the NHS plan represents a larger privatisation than even the Tories planned.Curiously, the plan also recognises the failure of past privatisations.I remember unsuccessfully voting against the privatisation of cleaning at the London Hospital when I was a board member of the old Tower Hamlets Health Authority.Squalid wards followed, and they remain with us now.The plan recognises that this policy was a disaster.Altogether £30m of cash is to be injected into hospital trusts before the next election to pay for the consequences of this mistaken minor privatisation.How much money will we have to spend in five, 10, or 20 years' time to correct the disastrous policy of major privatisation that we are now heading for?Mr Milburn, think again, before it is too late.
To Sterilize an Astronaut
Authors: Frederic W. Taylor
Journal: JAMA (1971)

<h3>To the Editor.—</h3> The precautions imposed on returning astronauts in an attempt to prevent a mysterious moon infection from contaminating the earth are truly unbelievable. That the dramatic efforts taken by these intelligent and scientific doctors could in any way alter such a situation is difficult to understand, nor is it possible to understand mental processes which justify the various quarantines and isolations imposed. Suppose this disease factor is similar to those encountered on earth. It certainly would have become evident, be it virus, bacteria, enzyme, or whatnot. Also, so far as we know, none of these could survive the riggors of the moon for a short span of time, let alone millions of years. Should this mysterious death-dealing factor be other than those with which we are familiar, as surely it must, then man's puny efforts at prevention would go for naught. Certainly any factor which survives the moon's
The Metabolism of the Stomach&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/xref&gt;&lt;xref ref-type="fn" rid="fn2"&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/xref&gt;
Journal: JNCI Journal of the National Cancer Institute (1949)
Hypertension Is Worth Treating
Authors: Zenonas Danilevicius
Journal: JAMA (1975)

Hypertension, although frequently asymptomatic, has many secondary effects and complications. Mortality is high; morbidity is even higher. However, the physician is often frustrated and discouraged because many patients with hypertension do not respond to treatment, and their blood pressure cannot be brought to normal levels. Recently, Taguchi and Freis<sup>1</sup>showed that even when blood pressure is not lowered to normal levels, there can be considerable benefit from drugs. The incidence of cardiovascular complications in patients with treated but only partially controlled hypertension was found to be only half of that in untreated patients. It would seem, then, that treatment is effective despite only partial reduction in blood pressure. Taguchi and Freis based these conclusions on their work in the Veterans Administration Cooperative Studies on Antihypertensive Agents.<sup>2</sup>Of 380 patients whose initial diastolic blood pressure readings were in the range of 90 to 114 mm Hg, 186 patients received
The National Center for Health Care Technology
Authors: Seymour Perry
Journal: JAMA (1981)

THE NATIONAL Center for Health Care Technology (NCHCT) was established by an act of Congress (Public Law 95-623) to provide a forum for the assessment of health care technologies. It is responsible for undertaking and supporting research and for synthesizing the results of such research to offer providers, consumers, industry, and government agencies concerned with health reliable and broadly derived information on which to base their decisions. The Center is not a regulatory agency, and it is not intended necessarily to be a vehicle for cost containment. The initiation of a feature inThe Journal, NCHCT UPDATE, will greatly enhance information dissemination activities of the Center. This article describes the mandate to the Center, its history, its operating guidelines, and its activities to date. Future articles will contain reports of the scientific basis for Medicare coverage decisions, summaries of the findings of technology assessment forums, and descriptions of research activities.